Healthcare Provider Details

I. General information

NPI: 1093700296
Provider Name (Legal Business Name): WILLIAM F GABBERT JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 W GREENWAY RD STE 150
PHOENIX AZ
85053-3731
US

IV. Provider business mailing address

3850 W GREENWAY RD STE 150
PHOENIX AZ
85053-3731
US

V. Phone/Fax

Practice location:
  • Phone: 480-508-5777
  • Fax: 480-508-5771
Mailing address:
  • Phone: 480-508-5777
  • Fax: 480-508-5771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number3813
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number3813
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: